Sunday, August 8, 2010

Come tour my craft room!

Hi all!
This weekend I have been working on my craft room/office. We have had a queen bed in this extra bedroom, but since we have few visitors out this way, we have moved the bed out of the way (but still easily set up for guests!), and I have been arranging things to be productive/creative.
This is the view when walking in.

Here is my desk, looking out on the street.  Don't you love the little Fisher Price doctor case turned pencil box?

This is a lovely textile that dear Sarah and Leo got me when they were in Nepal for the WWOOF conference.  It has a very interesting texture, it is very stiff, almost like it is starched or like celluloid.
Here is the little zipper pouch they brought back too.  I have just rediscovered these as I was unpacking stuff, since it arrived originally right before we moved here.
These are my hanging terrariums.  I hollowed out light bulbs, crocheted a holder, and planted small plants.  They are  over 5 months old now, and I only watered them once yesterday since I made them.  They are awesome!
The burlap sack is a potato sack I talked a local farmer into letting go for $1.  He didn't really want to part with it but my enthusiasm won him over...  It says Wisconsin Certified Seed Potatoes  Badger State Brand Registered.  I'm going to do something awesome with it, but for now it covers my chair.
Here is my new sewing station.  The vintage linen behind I got at the thrift store, and it really brightens the place up.  It is covering the bed that can be flipped down easily for guests, and I can pin right onto it if I want!  Yes, that is 3 rolls of duct tape in the left bottom corner, a duct tape double is coming soon...
The stash and other crafty supplies, mostly neat and organized.
Ironing area.  Gotta iron for another day at the hospital tomorrow, but it will be much nicer to do so now.  The fabrics hanging on the right are sarongs (so wrong, but so right)  that have been turned into curtains on the closet after I removed the double doors.  I keep all my clothes in this room too, so DH has plenty of room in our bedroom.  It works because I usually have to get up really early, and he works nights often and needs to sleep.  The painting is from a lovely artist in Puerto Rico.  
Close-up of the dresser top.  Glass perfume bottle courtesy of Melissa, woven seed saver from Leo, lotus candle holder from Autumn.  Thanks friends!
What's not to love?!?
Oh, the small details...
Thanks for coming on my little tour!

Saturday, August 7, 2010

Follow my blog!

Hi all,
Just a reminder that you can follow my blog by signing in to the google dashboard and then my newest posts will show up in you dashboard. Or you can have your settings so it emails you when I post. Or you can subscribe.
And, feel free to leave comments too! That way I know if anyone is out there!
Love,
Jess

PS
Wow 2 posts in one day!

Today is a new day!

Ok, so I have a new goal, to post weekly! I would like to get into the swing of this blog thing. It is summertime in lovely Milwaukee. Actually starting this week, I am spending my weekdays in Madison, and coming back for the weekends. This will be for several months. I am enjoying my current rotation. The schedule is light enough that I have been commuting almost daily, and I am really enjoying learning to read radiological images better. Xrays, CT scans, MRI's, and then there are the Ultrasounds, which are harder. But this is a great skill developing time. I think I've decided that I really like it when there is a specific goal, and skill to be developed. It is much easier to see that I am making progress, than other more nebulous goals like "understand diabetes management". I mean, there is a basic understanding, there is intermediate understanding, there is advanced understanding, there is researcher level understanding, there is patient level understanding, etc. It is rarely specified when we reach the 'good enough for this level of training' stage, and so I constantly feel inadequate. Here, the requirements are basic and laid out. They want us to be able to see pneumonia, collapsed lungs, dissecting aortas and have a basic grasp of other concepts. They don't expect us to be radiologists. It is very nice and respectful. Hooray for reasonableness and adult style education!

I went to the Family Medicine National Conference for Students and Residents, which basically had all the residency programs in the country to talk to. One of the programs I talked to had just restructured their residency to be based on adult education theories. This is unbelievably rare in this field. For incoming interns (first year of residency), they have them start for a few weeks, and then they take them out of the hospital for a few weeks to reflect and design their own learning course. This is truly innovative. I wish I wanted to move to Allentown, PA, because that program seems amazing.

One thing that can be terribly frustrating is not having much control over my schedule. The medical school can be so unreasonable. I was just denied a request to be absent on the Tuesday after Labor Day. I am going to be going to a wonderful wedding that Sunday, and I would have liked to stay an extra day to visit with family. I can't come a day early because one of my closest friends in med school is getting married in Milwaukee that Sat. I am going to appeal it, however it is unlikely to be approved at this point. If it wasn't a transition point, I would just work it out with my team (even though this is not what we are supposed to do, it is often the only way to make this type of thing happen). One day of training will not make a difference, and I offered to make it up with either my team or an extra day of call. They are so inflexible, and this is infuriating sometimes. It feels quite disrespectful. Anyway, this is just an example of the challenges in the system.

I just wrote a long email to a dear friend, and a portion of it seemed relevant, so I am going to share it here. Recently I posted on facebook that I missed my old life. Thanks to all of you who responded that my old life misses me too.

"I do really miss my old life. Right now it is just about one day at a time, one foot in front of the other. Less than one more year to go. I am having many doubts about going in this direction in my life. I am not changing course right now, but having some misgivings. I am hoping it will all work out in the end, and I'm sure it will because I will make it, but does happiness lie at the end of this road? I'm not exactly sure. I do know that this system blows big time. I hate the hospital/managed care environment, but I probably knew that before I started. The medical-industrial complex, as someone recently reminded me of this terminology, is messed up. It hurts patients and staff. It is a societal problem though. This goes back to realizing that our society is messed up. I think that we can do our part and leave a positive impact. I also think that I miss my bubble world which runs by slightly different rules that make more sense to me. There are tons of studies on how medical students become the most cynical at the end of third year. I thought, "this won't be me, I am a positive person", but here I am. I think it all hit me about a month ago. The people I've helped care for, the breakdowns in the system, the nasty comments about patients, students, nurses, doctors, everyone. It can be really painful. I think I romanticize that being in CA would be different, but I think it would likely be similar. I am constantly treading water just to stay in the same place, much less get swept away by the current or swim upstream. There are good people here, and the integrative medicine departments are good, and family medicine has lots of great people in it. I feel very sure about the field I am going into. I think it will help when I am in residency to be surrounded by these colleagues more of the time. These are people who value people, who know that being healthy is more than physical ailments. The ends do not justify the means, the process is equally important. I just really hope that I can Match into a program where I am valued for my background and training, and for my unique perspective, as well as a program that supports its residents amazingly well. So that is on my mind these days as well as the process is beginning."

Oh yes, the Match process is looming in every 4th year medical student's mind right now. This is this crazy process where you apply to residency programs, then go on interviews. At the end of this in February, all applicants submit a list in rank order of every program they would be willing to go to, and every program submits a rank list of every applicant they would be willing to accept. Some computer runs some crazy process to Match it all up, and then on the third thursday in March, everyone across the country finds out the results at the same time. So March 17 is gonna be a crazy day. However the process of applying is beginning now, so it can be hard. Writing a personal statement is so difficult because it is supposed to be great, convey who you are, and be witty too. These are the attributes of great writing, and while I may have been a better writer before, I have certainly not been writing much lately.

So I called this post "today is a new day" because it is true! Everyday is a new day to reinvent yourself, to re-experience life! I have been re-membering myself, and part of that is re-embracing my pre-med school self, and focusing on bringing more mindfulness to my daily activities. Being present in the here and now is all we truly have.

Lastly, this week is Jerry Week, the week encompassing Jerry Garcia's birthday (Aug 1) and passing day (Aug 9). I have been listening to some amazing music, interviews, and analysis of his musical talent and development. It is wonderful and a blessing to have his legacy continue.

So, Happy Jerry Week to all, and love life and each other as best as you can!

Wednesday, March 10, 2010

At large in Milwaukee

The last few weeks have been mostly fun, despite my last post. We have finished Ob/Gyn, and then had 2 weeks of public health training, cultural exploration of Milwaukee, and time to work on our projects. The first day we met with a local historian about the local history of Milwaukee, and met with the medical director of Milwaukee Public Health department who is a great family doc. The variety of work they do in that department is fascinating, everything from vaccinations, STD notifications, restaurant inspections, public education campaigns, and infectious diseases. The next day we spent learning a technique called Asset Based Community Development. The basic idea is that every community that has needs and problems, also has assets, and using and amplifying these assets is the quickest, most sustainable way to improve a community.

The next few days were spent culturally touring Milwaukee. We went to an amazing Latino community center that houses an wonderful art gallery which gets traveling shows from around the world; an elementary and middle school with children who are succeeding amazingly by all objective measurements including tracking through college; a senior center with arts and crafts, games, laundry, meals, and a mean game of pool; low income senior apartments with such a long waiting list that 40 more units are being built this summer; an adult care center for daytime care of seniors with Alzheimer's and dementia that is designed to look like a plaza in Latin America, as people revert to their earliest memories; and a delicious cafe with Mexican and Puerto Rican specialties. Then we went to a delicious Polish restaurant for lunch where we ate fresh pierogis, saurkraut, sausage, broad beans, and latkes with applesauce. YUM!!! Then we went to a Latino artist who makes life sized paper mache dia de las muertes skeleton people, among other cool art. We then went to a little botanica, a Latin store for herbs and other items. The owner was also a practitioner of Orisha and Santeria, Carribean blend Catholicism and African-based Yoruba. Her cute little shop had all sorts of herbs, oils, statues, charms, and everything you would need. I bought a small statue of La Virgen de Guadalupe, as I wanted to have her amoung my pantheon of goddesses on my altar and she represents to me the ability of people to adapt their beliefs to survive an oppressive colonialization. My friend who's wife was expecting to deliver any time as it was 1 week before her due date, was given a Jericho rose, an interesting artemesia plant that is found in desert regions. It grows in a rosette formation and when dried it curls in on itself. He was instructed to put it in water when his wife went into labor, and it would slowly open. To me that seems like part of a longstanding tradition in herbal medicine where if a medicine looks like something, it must treat that thing. So the rose opening up as it rehydrates, seems quite similar to the slow opening of the cervix in labor. This also coincided well with the flowers the couple had been using for this opening type visualization.

After that, we went to St. Josephat, the Catholic cathedral. It is quite beautiful, built from stone around the turn of the century by parishioners who had recently come from Europe, bring their craftsman skills with them. It is elaborately carved, with a huge dome that can be seen for miles. Beautiful stained glass too. I guess this church is a bit controversial because they have put a Virgin of Guadalupe, a Mexican appearance of the Virgin Mary, up on the altar, however it seems like quite a mix of folks use this church, from the descendents of those who built it to the burgeoning Latino population. We were there on Ash Wednesday, so we didn’t stay very long as the church was in constant use, however it was fortunate to coincide with pro-life month and I read some fascinating literature on Planned Parenthood. It seems they are trying to get new customers all the time so they can make money, and they do so by forcing people to take birth control pills and engage in sex acts. The more sex people have, the more abortions people have, and the more money they make. And people get married every year, so they must keep their clientele increasing constantly. I kid you not, this brochure was amazing in its craziness!

It was especially interesting to read because I had spent an afternoon a few weeks ago at the abortion clinic. This is the second time I have done this, and the first time is a lot to take in, but now that I have more clinical experience, it was quite interesting in many ways. The women that were there were from all walks of life, a 15 year old with her mother for support, married women in their 30’s and 40’s who knew they couldn’t take care of more children, women with 10+ children already, women with no children trying to get more education, and most women had partners and friends with them. Many of them had had failed birth control, one even had an IUD that was still in place. In terms of embryonic to fetal development, before 8 weeks, it simply looks like feathery snot. There are no recognizable human parts at all, it is simply tissue and mostly looks like a menstrual period. As time goes on, there is further development and what most people think of a fetus starts to take shape. If you ever decide to have a therapeutic abortion or induced miscarriage (same thing), try to do it early. It is better for you and less difficult too. They don’t use general anesthetic here in Wisconsin, and most women were unmedicated. Some elected to use a little valium combined with a drug called Versed, which causes you to forget about 30 minutes right after you take the drug. This is called twilight anesthesia, and they use it for other procedures like colonoscopy too. Talking to these women, and post colonoscopy patients too, frequently they are in the recovery room asking when they are going to have the procedure done. However the medication certainly is not necessary, as the entire procedure takes about 5 minutes, which includes the pelvic exam and speculum insertion. It is like a slightly more uncomfortable annual pelvic exam. The thing that stands out to me the most about that day is the gratefulness of the women. They were all so thankful, and many had tears in their eyes when expressing their gratitude. Many expressed, that although it may or may not be a challenging decision, they appreciated the services offered and felt it supported them in living their best lives.

The next day we spent visiting a black theater group, in which one of the nationally acclaimed artists had written a series of monologues on the experience of being a black man in the US. These were performed for us as a private group, and it was so moving and powerful. The pieces spoke poignantly on issues of being a father after growing up fatherless, about the struggles of drug addiction from the perspective of the addicted person, and the challenges and fears of returning to the community as a man after going to prison as a young boy. The actors were quite skillful in using their bodies and clothing as well as their voices to portray these amalgamations of people the author has known including himself.

After that, we went to a tiny black church the size of a house, and had a private performance from the Queens of Harmony, a traditional a capella gospel quartet. These ladies have been performing for many years, and the power of a private performance combined with the strength of their singing was amazing. I plan to go see them again in August at their anniversary party, which apparently goes on for many hours with visiting groups. They were all so sweet too, welcoming us with hugs, and telling us how their singing and their faith had helped all of them through some of the most difficult medical situations imaginable. Many had had cancers, and other significant health challenges, but felt that the music and the community had given support and kept them going through the toughest times. After this, we went to a soul food diner, where we had the best fried chicken I have ever had, collard greens, okra, and I even tried some chitterlings, which were disgusting, by the way. But lots of folks ate them up, especially with hot sauce and vinegar. We then went to a fancy hat shop, and tried on some great hats. There were definitely fancy church hats here, but also other nice hats, and a bunch of folks bought something.

We finished out the day at another community center, in a black neighborhood that had been partially torn down in the 60’s to make room for a freeway that never was built. So the neighborhood had been destroyed, neighbors scattered, and nothing built in its place. Over the years, the few boarded up houses had turning to flop house, brothels, and crime centers. In 1997, a woman who had grown up on the street in nicer times, moved back into her parents house she had inherited, bought the flop house across the street for $500, that was about to be demolished and began doing restoration work. It took many years, but Walnut Way Community center was born here, and now lives in a beautiful, 1920’s house that has been meticulously restored and beautifully decorated. The center has grown over the years to have a community garden and orchard where they employ young people in the summer to grow food, tend the trees, and gather honey, and sell it all to the neighborhood and at the local farmer’s market for the center. Each person receives a stipend for their work. There is also a 4H club for 5th -12th graders, a health advocate training program to train community members to be health resources, a cooking club to teach healthy cooking skills, a neighborhood walking group, as well as quarterly open houses to promote the neighborhood and people knowing each other. They have coordinated a block party every year, and they have a neighborhood buying cooperative to help conscientious people, instead of distant landlords, buy houses on the block as they come on the market. A most amazing place, and the woman who started it all Sharon Adams, has just been named one of Milwaukee’s top visionaries of 2010. The nice thing about this center is that is feels nice as well as having nice programs. The rooms are decorated and painted in pleasing ways with wonderful artwork that inspires. There is a compost bucket in the kitchen and al arge island in the center for group food prep. The yard and the yard across the street have raised beds, many fruit trees, and bee boxes.

All in all, a wonderful taste of the bounty that Milwaukee has to offer. It is wonderful to have such an inside view and I continue to like this new city home of mine more and more.

Monday, March 1, 2010

'March'ing along

Welcome to March all!
The time that I have spent here in Milwaukee so far has been very special. I am enjoying being a part of a larger, vibrant, oozing city.

However I must be honest. While I don't want this to be a down type of blog, I also want to be honest about what I am feeling and experiencing. I debated a while about posting this, so I hope it will be met with compassion and understanding.

I have been struggling with depression quite a lot in the last week. It has been hard. It really hit me this past week when I was done with my time on Ob/Gyn and the reality of what I had been through had time to percolate to the top. I think the combination of February snow/cold/lack of sun, PMS, the pressure of Ob rotation, the reality of dealing with the only terrible group of residents I have encountered, the pressure of working on my project and feeling like I need to take it to a different level with all the public health tools and literature available and the limited time I have as a med student to do so. While I have dealt with this issue of depression many times before in my life, the prevalence among medical students is astounding. About 22% of med students suffer from depression, versus 10% of non medical peers. I am linking some good (short) articles here if anyone wants to see what others have had to say...
here
here
and here

However the main pressure I think has been a feeling of being trapped in the box, with no escape possible. I feel like a cow being herded from one cattle chute to another, and that there are just more chutes ahead. How did my life turn into this? Where is the person that I used to love to be? I never thought that pursuing education and training would make me feel like I had fewer options rather than more. The difficulty of losing myself, the self I worked hard to cultivate, is almost unbearable at times. I know that self is still there, and that there are changes too, but to know that self still, to feel it, is really hard sometimes, except the suffering.

I used to live in a world of magic, fun, love, friendship, intention and synchronicity. Now, much of that seems to be changed. I am in a box of mime-like ever narrowing proportions, each bit of individuality and joy squeezed out to attempt to fit a cookie cutter mold. Sometimes I resist, other times I am too tired or its too hard to figure out how to be parts of me while still meeting certain requirements. I mean, I even have a dress code now. I never imagined when I started this process how grueling, demanding, and just plain hard it would be. I knew it would be hard work, that part is fine. This last rotation, which was definitely the worst so far, I spent every day, not only being the stupidest and most useless one, but not even being a person worth teaching or acknowledging most of the time, unless it was to be condescended to or humiliated. That really was painful, and continues to be so. Who treats people this way? How can someone ignore you, despite preparation and direct questions, for 14 hours a day, while you attempt to work side-by-side? The one consolation, however small, is something one of my classmates said, "remember its not you, its them!" While I don't usually approach it like that, sometimes it is clearly true.

I really miss having a life outside of school. All our friends, all our social outlets, are through school. We've been trying to go out in the city more often, but DH and I have opposite schedules these days, with him working and schooling at night, and my long days. It can be hard to break into a scene, especially when you have little time. I was at DH's pizza restaurant the other day, and a dready couple were in there, ordering food. I had just come from clinic, so was dressed "professionally", and even though I smiled at them, it was obvious they would never have thought I was someone they would talk to. I have lost my freak flag y'all! No more patchies, no dready do's. Trying to figure out how to keep it real and keep it free.

Anyway, I will end here, I have whined enough. Needless to say, this is a painful part of training. The bright side is that I start primary care today. This is a combination of family medicine and outpatient internal medicine. By far, the family med residents rotating through Ob were the ones who were kind, who wanted to help you learn, and who treated me like a human being, without fail. This gives me hope that this rotation will be much, much better. I am a bit nervous because I really want to do well, to like it, and to be liked here, as this is the field I am wanting to go into. But 3 of the faculty I have met have been great as well, so chances are good.

I will try to write more interesting and good stuff too. It just seems I have more to reflect on sometimes on the things that don't go well. As one of my wonderful teachers says, "we humans are programmed to notice what isn't right. It is what keeps us working on making things better."

Sunday, February 7, 2010

beginnings...

Today I had a bit of the downs:( Sometimes I feel like life is so impossible, but usually that means there is something getting me down. I spend most of my time trying to retain the positive perspective on things, that sometimes I don't check in enough to see how I am processing all this stuff going on. So this morning I had a good cry with DH, and it relieved some of the pressure. This rotation I am on has some really hard parts to it. The issues surrounding birth in this hospital setting are huge. Often, mom's don't hold their babies for an hour or more, after a perfectly 'normal' delivery. The modus operandi here is pitocin, to make labor as hard and fast as possible, epidural so the mom can't feel the extra pain from the pitocin, and then 'git 'er done!', meaning constant cervical checks (sticking their fingers in the vagina) so they can know the instant it is possible to push, regardless of the rest period that sometimes comes between dilation and pushing. Then as women push, they are rarely given true encouragement, only generic comments which frequently border on criticism. I have been told by one of the attending physicians that the faster we can turn these rooms around, the more money we make! While this may be strictly true, to have that said in the context of a sacred event such as birth sickens me. Most of the women birthing here have had little pre-natal care, and are on public insurance. While I was told during orientation that kangaroo care (immediate skin-to-skin contact for mom and baby, no cleaning up or other stuff) is optimal for many, well researched reasons, I have yet to see it happen or even be offered. Very few moms are breast feeding, and those that are, are not encouraged to begin immediately. There have been multiple times, when I am at the end of the bed, gowned, gloved, and masked, and I have been told to "get out of the way" so the doc can rush the newly birthed infant to the table to be weighed, cleaned, measured, and examined. People make disparaging comments about bodily fluids, the poop and blood that are a part of the messiness of life, and certainly part of the birthing process. Five people who are not the mom or other people in the baby's life touch, poke, prod, and admire before mom or dad get a chance. These people are gloved as well, which is good because you want baby to be populated with the family's bacteria first, but I can't imagine what it must feel like to the infant to not have the comfort of human skin immediately, the sound of the heartbeat that was with you from the moment of conception. I am such a big believer in the concept of begin as you mean to go on, or that beginnings are extremely important. These energetic signatures carry with us for a long time.

Now, don't get me wrong, I think that birth, as a gateway between worlds, is an inherently dangerous and powerful time. It used to have high mortality rates, for both infant and mother. Now it is an extremely safe process which usually has a good outcome. I appreciate that, on multiple levels. The safety factor of today is a wonderful blessing to many. Ultimately, the outcome is healthy mom and healthy baby, at least for as long as I see them in the hospital for a few days.

I am not talking about the times when there is some degree of danger and there needs to be an intervention or the neonatalogists need to be involved. And some of these behaviors may come from over-exposure, the factory type environment which leads to better outcomes through repetition, the Henry Ford model. The shine wears off for some of the doctors and nurses who deal with it day in, day out.

It just seems to me that there is some degree of humanity that is lost when we can't greet the heralding moments of life with the sacredness that they are due. It has been said that a this time in my training I am closer to the perspective of a patient than a doctor. And that may or may not be true. I often feel that I am somewhere in between. But I can hope that I will never lose that perspective of what these moments mean to the person going through it. And these outcome measures need to include the psychological or emotional aspect as well, because I think they are failing on that end.

PS I think that it is different in some hospitals. Another hospital about an hour from here has all patients fill out a huge questionnaire about preferences from everything such as music during labor to kangaroo care to feeding preferences. I'm not sure if it is just the culture of this place, or it is what happens when the majority of women are poorly educated, and not well empowered.

Sunday, January 24, 2010

I've been wanting to start a blog for a while now. I know many of you have let me know that you missed my emails and I was so busy for a while that I just couldn't send them. Sometimes I would journal what I wanted to say to you, but it never got typed up and the moment would pass. I'm just going to start with where I'm at in the present, but maybe some of those other thoughts will re-appear in the right time.

This blog is named after the Ice Cube song, (which samples the classic Grandmaster Flash's "The Message", check out the link for some amazing costumes and dance routines) in that I need to check myself to not lose what is important. This process of medical education continually makes me re-evaluate what I formerly knew to be true, and I don't want to fall in lock-step with the prevailing notions that are strongly swirling around me. I want to come through this process with my essential self intact, my humanity and compassion strong, and with a feeling of positive growth and development from this time in my life. I want to sift and sort, keeping what is valuable from both old and new, to forge a new, better version of myself each day. I hope this can be a place where I can share my thoughts and experiences, and have you, my nearest(to my heart) and dearest, share the journey with me. So help me to check myself before I wreck myself! (Unless I can get wrecked with the Wrecked Crew, which would be a nice change these days!)

Currently I am in Milwaukee, in my 3rd year of training. It is so much better now that I get to interact with patients and participate in their care on a daily basis. Intrinsic rewards. This is a sharp contrast to the past 2 years which were based on lots of memorization of barely useful facts without any context to frame them. Though the process of medical education is changing, it is changing slowly. Many people have described it as a hazing process, or a culture of abuse that cycles from generation to generation, and so far that seems apt. Like all hazing, not everyone is a major contributor, but the ones that are are noticeable, and they have a lot of power and control, so navigating that is challenging, to say the least.

I am starting my 4th week on Ob/Gyn. So far I have been present at multiple people being told they have cancer, have examined many pelves (plural of pelvis), worked with doctors, nurses, midwives, and residents, (midwives are still by far the best), done lots of prenatal visits complete with pregnant bellies, kicks, and fetal ultrasounds, helped deliver 4 babies, and 1 case of fetal demise in the middle of the second trimester. I am about to go on a full week of nights in Labor and Delivery, which is 6pm, to 8 am, so I will get lots more time with laboring and birthing folks! So far, all the mom's have had epidurals, none are breast-feeding, and the process of delivery was less than optimal. However, mom's choice, and so far healthy mom, healthy baby, is the outcome. The fetal demise was sad, however the day before I had just gotten a wonderful talk on grief counseling and infant mortality. Milwaukee is shocking in its stats on infant mortality, they are double the rest of the state, and black women are triple the state average, on par with developing countries like Mexico, Nicaragua, and El Salvador. It is terrible, and mostly preventable. However this talk was amazing, and it really helped me to be sensitive and know what to say to the family that had lost this pregnancy. They were a young family, in their early 20's, with 3 young girls at home. They were going for a boy to round out their home, and unfortunately, this one didn't make it. After she delivered, there was a lot of crying, and both mom and dad, but they held the baby, and had friends come and see the baby. One thing that really helped was to notice how beautiful the hands and feet were (because fetuses at this stage are humanoid, but their bony structures aren't really solid yet, so they do look a bit alien), to talk about the names they had picked out, and to generally just be supportive. It was a really supportive environment for such a sad event. The nurse caring for them was amazing, she did and said all the right things, and was incredibly caring and kind. However, there was one exceptionally jarring time in this event, when another nurse came in and was dead set on 'filling out all the paperwork, there are so many forms...Fetal demise..." all in a very loud, scratchy, disruptive voice. I was literally making subtle hand motions trying to shoo her out the door, but there is always a fine balance being a student, especially since the resident was in the room, about contributing appropriately but not overstepping my bounds. About 5 minutes into it, the resident finally asked if we could have this conversation outside the room. The nurse didn't mean to be insensitive, and later took some lovely photos of the baby for the family. However it was a stark reminder to me of time and place. The delivery of the placenta had just happened, after some stress about it not coming down. It wasn't the right time for the paperwork to be the priority. It is easy to see how we can get lost in our routine, our job, and forget the people experiencing an intense moment right then.

On a happier note, part of my time here is to do a community project, and I am currently working with a free clinic that works hand-in-hand with an alternative clinic. They are housed in the same offices, and there is much referral back and forth. Currently I am gathering information to see how I can best be of service to the community. On friday, I interviewed 3 lovely people, both staff and patients. To hear how the existence of the alternative services, or integrated care has impacted people's lives in such dramatic ways was wonderful. I think I have somewhat forgotten about the power of these modalities, living in the cult of pharmaceuticals for so long. People have described how it has opened them up, allowed them to be positive, happy human beings, all while still dealing with the pressures of immigration, financial uncertainty, and illness from lack of ongoing care. I finally feel like I can re-access a part of myself that is locked away most of the time. I can't tell you how nice that is, both to be able to be more open myself, and to remember, as in re-member or reattach body parts, to myself.